Provider First Line Business Practice Location Address:
901 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KLAMATH FALLS
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97601-5810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-238-2289
Provider Business Practice Location Address Fax Number:
541-835-3322
Provider Enumeration Date:
09/14/2024